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MGMA Calls for HIPAA 5010 Contingency Plan
The Medical Group Management Association is calling for a contingency plan of at least six months for the transition to the HIPAA 5010 transaction sets, which has a compliance date of Jan. 1, 2012.
Under the plan, health plans would continue to accept Version 4010 transactions and adjudicate 5010 transactions that lack all required data. The association, which regularly surveys members and has previously warned that physicians and much of the industry remain unprepared for 5010, says federal officials need to expand the current contingency plan.
The Centers for Medicare and Medicaid Services in November announced a 90-day grace period for enforcement of 5010.
Read the full article at:http://tinyurl.com/888b2dm
Source: Health Data Management
Urticaria Diagnosis Challenged by Overlapping Pruritic Skin Conditions
April 23rd 2025Urticaria is complicated to diagnose by its symptomatic overlap with other skin conditions and the frequent misclassification in literature of distinct pathologies like vasculitic urticaria and bullous pemphigus.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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